The Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content>
ABSTRACT Whole-genome sequencing (WGS) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 228 (ST228) SCCmec I that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. Combin...
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American Society for Microbiology
2016
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oai:doaj.org-article:bab0dd3904094f67bf065d0364e2bdb52021-11-15T15:49:40ZThe Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content>10.1128/mBio.02039-152150-7511https://doaj.org/article/bab0dd3904094f67bf065d0364e2bdb52016-03-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mBio.02039-15https://doaj.org/toc/2150-7511ABSTRACT Whole-genome sequencing (WGS) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 228 (ST228) SCCmec I that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. Combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of ST228, rather than repeated introductions of this clone into the hospital. We note that this clone is significantly more frequently recovered from groin and rectal swabs than other clones (P < 0.0001) and is also significantly more transmissible between roommates (P < 0.01). Unrecognized MRSA carriers, together with movements of patients within the hospital, also seem to have played a major role. These atypical colonization and transmission dynamics can help explain how the outbreak was maintained over the long term. This “stealthy” asymptomatic colonization of the gut, combined with heightened transmissibility (potentially reflecting a role for environmental reservoirs), means the dynamics of this outbreak share some properties with enteric pathogens such as vancomycin-resistant enterococci or Clostridium difficile. IMPORTANCE Using whole-genome sequencing, we showed that a large and prolonged outbreak of methicillin-resistant Staphylococcus aureus was due to the clonal spread of a specific strain with genetic elements adapted to the hospital environment. Unrecognized MRSA carriers, the movement of patients within the hospital, and the low detection with clinical specimens were also factors that played a role in this occurrence. The atypical colonization of the gut means the dynamics of this outbreak may share some properties with enteric pathogens.Laurence SennOlivier ClercGiorgio ZanettiPatrick BassetGuy Prod’homNicola C. GordonAnna E. SheppardDerrick W. CrookRichard JamesHarry A. ThorpeEdward J. FeilDominique S. BlancAmerican Society for MicrobiologyarticleMicrobiologyQR1-502ENmBio, Vol 7, Iss 1 (2016) |
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Microbiology QR1-502 |
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Microbiology QR1-502 Laurence Senn Olivier Clerc Giorgio Zanetti Patrick Basset Guy Prod’hom Nicola C. Gordon Anna E. Sheppard Derrick W. Crook Richard James Harry A. Thorpe Edward J. Feil Dominique S. Blanc The Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> |
| description |
ABSTRACT Whole-genome sequencing (WGS) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 228 (ST228) SCCmec I that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. Combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of ST228, rather than repeated introductions of this clone into the hospital. We note that this clone is significantly more frequently recovered from groin and rectal swabs than other clones (P < 0.0001) and is also significantly more transmissible between roommates (P < 0.01). Unrecognized MRSA carriers, together with movements of patients within the hospital, also seem to have played a major role. These atypical colonization and transmission dynamics can help explain how the outbreak was maintained over the long term. This “stealthy” asymptomatic colonization of the gut, combined with heightened transmissibility (potentially reflecting a role for environmental reservoirs), means the dynamics of this outbreak share some properties with enteric pathogens such as vancomycin-resistant enterococci or Clostridium difficile. IMPORTANCE Using whole-genome sequencing, we showed that a large and prolonged outbreak of methicillin-resistant Staphylococcus aureus was due to the clonal spread of a specific strain with genetic elements adapted to the hospital environment. Unrecognized MRSA carriers, the movement of patients within the hospital, and the low detection with clinical specimens were also factors that played a role in this occurrence. The atypical colonization of the gut means the dynamics of this outbreak may share some properties with enteric pathogens. |
| format |
article |
| author |
Laurence Senn Olivier Clerc Giorgio Zanetti Patrick Basset Guy Prod’hom Nicola C. Gordon Anna E. Sheppard Derrick W. Crook Richard James Harry A. Thorpe Edward J. Feil Dominique S. Blanc |
| author_facet |
Laurence Senn Olivier Clerc Giorgio Zanetti Patrick Basset Guy Prod’hom Nicola C. Gordon Anna E. Sheppard Derrick W. Crook Richard James Harry A. Thorpe Edward J. Feil Dominique S. Blanc |
| author_sort |
Laurence Senn |
| title |
The Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> |
| title_short |
The Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> |
| title_full |
The Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> |
| title_fullStr |
The Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> |
| title_full_unstemmed |
The Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant <named-content content-type="genus-species">Staphylococcus aureus</named-content> |
| title_sort |
stealthy superbug: the role of asymptomatic enteric carriage in maintaining a long-term hospital outbreak of st228 methicillin-resistant <named-content content-type="genus-species">staphylococcus aureus</named-content> |
| publisher |
American Society for Microbiology |
| publishDate |
2016 |
| url |
https://doaj.org/article/bab0dd3904094f67bf065d0364e2bdb5 |
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